Chemotherapy Treatments for Hodgkin's Lymphoma

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Hodgkin's lymphoma represents one of the great success stories in cancer research. What used to be a death sentence of a diagnosis has become highly treatable and curable across almost all stages of the disease. One of the primary reasons for this is the development of combination chemotherapy regimens designed to work against the disease.

MOPP

The MOPP combination chemotherapy regimen, developed in the 1960s, was the first such regimen that yielded results in Hodgkin's patients. It is composed of the following drugs:

  • Mustargen
  • Vincristine (Oncovin)
  • Procarbazine
  • Prednisone

MOPP has a place in the historical annals, but it doesn't have much of a place in modern anti-cancer medicine, chiefly because much better, less toxic, and less carcinogenic regimens have been developed.

ABVD

The ABVD combination chemotherapy regimen, developed in the 1970s, took the place of MOPP as the standard of care in Hodgkin's lymphoma—a place it retains today in many of the world's most influential oncology treatment guidelines. It is composed of the following drugs:

  • Adriamycin
  • Bleomycin
  • Vinblastine
  • Dacarbazine

ABVD is not without its problems, however. Adriamycin can be cardiotoxic, and bleomycin is toxic to the lungs. And like MOPP, the regimen raises the risk of developing a secondary cancer later in life.

BEACOPP

The BEACOPP combination chemotherapy regimen, developed by the German Hodgkin's Study Group, is regarded as the standard of care in Germany and is considered effective for certain specific diagnoses of Hodgkin's in other countries, including the United States. It is composed of the following drugs:

  • Bleomycin
  • Etoposide
  • Adriamycin
  • Cyclophosphamide
  • Oncovin (vincristine)
  • Procarbazine
  • Prednisone

The BEACOPP regimen continues to undergo testing in efforts to make the regimen less toxic while retaining its efficacy.

Stanford V

In the late 1980s, researchers at Stanford University developed the Stanford V regimen in an effort to scale back some of the problems perceived with the ABVD regimen. It is composed of the following drugs:

  • Doxorubicin
  • Vinblastine
  • Mechlorethamine
  • Vincristine
  • Bleomycin
  • Etoposide
  • Prednisone

Like BEACOPP, some research suggests that Stanford V is more effective for specific stages of Hodgkin's lymphoma, although this assertion has yet to be accepted by the wider lymphoma community.

Continued Advances

Despite achieving extraordinary success with combination chemotherapy, researchers continue to tinker with dosing schedules and other aspects of these treatments in an attempt to bring the toxicity levels down while maintaining the efficacy. There are even ongoing trials to introduce Seattle Genetics' Adcetris treatment into ABVD therapy by replacing the bleomycin with Adcetris. Only time will tell, but progress made by chemotherapy treatment against Hodgkin's remains a model for research and treatment into other malignant cancers.

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